Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $108.83 / $1,967.00 / $9,534.00	Facility		$108.83	$1,967.00	$9,534.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.01 / $103.40 / $180.05	Professional		$87.01	$103.40	$180.05
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $133.28 / $220.69 / $220.69	Professional	50	$133.28	$220.69	$220.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $1,927.00 / $3,943.00	Facility		$937.00	$1,927.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.58 / $99.34 / $208.53	Professional		$68.58	$99.34	$208.53
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $102.87 / $149.01 / $312.80	Professional	50	$102.87	$149.01	$312.80
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $103.09 / $103.09 / $103.09	Professional		$103.09	$103.09	$103.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $83.72 / $145.40 / $177.90	Facility		$83.72	$145.40	$177.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $100.81 / $118.84 / $185.39	Professional		$100.81	$118.84	$185.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.68 / $68.78 / $21,571.00	Facility		$61.68	$68.78	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.58 / $128.91 / $247.39	Professional		$86.58	$128.91	$247.39
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $61.68 / $61.68 / $68.78	Facility		$61.68	$61.68	$68.78
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $91.23 / $127.73 / $203.53	Professional		$91.23	$127.73	$203.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $82.48 / $112.43 / $154.20	Professional		$82.48	$112.43	$154.20
United Facility/Professional Facility Modifier Low / Median / High Price $226.00 / $881.00 / $2,833.00	Facility		$226.00	$881.00	$2,833.00
United Facility/Professional Professional Modifier Low / Median / High Price $89.57 / $116.68 / $217.88	Professional		$89.57	$116.68	$217.88